Provider Demographics
NPI:1588869382
Name:RAGHUWANSHI, NAISHADH NAVAL (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:NAISHADH
Middle Name:NAVAL
Last Name:RAGHUWANSHI
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25495 MEDICAL CENTER DR STE 306
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4904
Mailing Address - Country:US
Mailing Address - Phone:951-304-3900
Mailing Address - Fax:951-304-3901
Practice Address - Street 1:25495 MEDICAL CENTER DR STE 306
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4904
Practice Address - Country:US
Practice Address - Phone:951-304-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005013747390200000X
CAA102238207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program